By Jestelle Irizarry Disneyland, or more recently known as “measles kingdom,” is bringing light to an important consumer healthcare topic: parents’ decisions whether to take advantage of preventive care or not. Chronic diseases—like heart disease, cancer, and diabetes—are responsible for seven of every ten deaths in the United States each year and account for 75 percent of the nation’s health spending, but Americans are only using preventive care about half of the recommended rate. Even parents with insurance are not getting the proper immunizations for their children and themselves or the check-ups necessary to keep their families healthy. Thousands of people were exposed to the measles recently, a vaccine preventable virus the U.S. declared eliminated over a decade and a half ago. The current outbreak of the measles, an extremely contagious respiratory disease, proves that vaccines can only protect people if the masses take advantage of them. In the 1960s, healthcare providers led a widely successful national campaign to educate consumers and encourage them to take advantage of vaccinations, including the measles. Now Americans don’t spend time worrying about the measles because in the 21st century, the virus has not been an issue. When the measles were supposedly “eliminated” in the U.S. in 2000, they didn’t suddenly stop existing, but rather the virus no longer had a constant presence. Since, many parents have disregarded recommendations to vaccinate their children and have exercised their right to not do so. As of February 6, 17 states have reported a total of 121 cases of measles, one third related to the outbreak at Disneyland in California. In 2014, the CDC reported a total of 644 cases of measles in the U.S., 383 of those occurring among an unvaccinated Amish community in Ohio that drew national attention. To compare, between 2001 and 2011, the average number of measles cases reported per year was merely 62. Clearly the measles is once again a virus that concerns the general public. Besides the measles, the whooping cough virus, another vaccine preventable illness,...
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Over the past few years, the number of companies that offer wellness programs and incentives to their employees has increased significantly. Companies are no longer just offering employees discounted memberships to gyms as a part of their wellness programs. The 60% of companies with wellness initiatives are offering incentives that range from fines for not completing preventative health screenings, to group fitness classes to even being paid bonuses for completing triathlons. Healthy employees save employers time and money, as they tend to take fewer sick days and are more productive in the office. Additionally, wellness programs are seen as effective method to lower or contain medical care; these programs are now more widely offered as part of comprehensive insurance benefits packages, and terms in the Affordable Care Act serve to encourage the growth of these initiatives. This $6 billion a year industry is growing in such a way that companies don’t even have to design their own programs. For example, VirginHealthMiles helps employers design programs to keep employees healthy that best fit the goals of the company. Wellness initiatives are investments, and just like any investment, companies hope to see a return. However, the kinds of returns depend on the goal of the wellness programs. If a company wants to improve the health and productivity of its employees, evidence-based lifestyle management programs are often the most effective. These programs focus on promoting healthy lifestyles, maintaining good health and preventing disease. For example, Safeway offers its employees a preventative-care health center, an on-site fitness center and health-focused cafeteria options. With the mindset that they are a “wellness company that happens to sell groceries,” Safeway has integrated health and wellness into its overall company mission, and its wellness program has participation rates of over 80%. On the other hand, if the goal is to achieve healthy ROI (in addition to healthy employees), employers should target their programs toward employees who have chronic diseases. A 2010 study done by Harvard found that for each dollar employees spend on wellness programs,...
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Accountable Care Organizations, a Bridge to the Multicultural Insurance Market? By Martha C. Rivera, Director of Strategy and Insights With the support of Anthony Gokianluy, Junior Executive Accountable Care Organizations, or ACOs, are the less visible component of the Affordable Care Act (ACA) in the health insurance news these days. ACOs, as created by the ACA, comprise distinct groups of providers that deliver coordinated long-term care and disease management to seniors and permanently disabled beneficiaries. The ACOs program aims to improve health quality while reducing the total cost of care under the Medicare program. While the ACA already stands to have a tangible impact on multicultural populations, ACOs can be an effective bridge between the US health care system and the newly-insured in diverse communities, who would likely have no prior experience navigating the health system and need culturally-relevant attention to partake in insurance plans. Nearly one out of four Medicare users is multicultural, where Hispanics represent close to 8% of the total Medicare beneficiaries. ACOs should establish a presence within these multicultural communities, particularly to Spanish-speaking patients, to help overcome cultural and language barriers and effectively reach out to them, as their share of the insurance market is predicted to significantly increase under the ACA. “ACOs are called to play a vital role in connecting with multicultural populations that the healthcare reform targets,” said George L. San Jose, president and chief creative officer at The San Jose Group. “ACOs can be drivers of increased enrollment in available insurance...
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By Martha C. Rivera, Director of Strategy and Insights With the support of Nicha Ruchirawat, Junior Executive Medicare Advantage, which is the Medicare health plan offered by a private company, is going through some changes under the Affordable Care Act. The main transformation is that Medicare Advantage plans rated three out of five stars by Center for Medicare & Medicaid Services (CMS) will receive bonus payments acting as an incentive for Medicare Advantage carriers to offer better quality care. Thus, in order for private insurers providing the Medicare Advantage programs to receive these benefits, they should act to effectively improve their programs. To efficiently increase quality care, it is important for providers to observe the trends of consumers being served. The consumer segment with population enrolling most often in Medicare Advantage is the Hispanics. An estimated 42% of Hispanics enroll in Medicare Advantage, compared to 29% of African Americans and 24% of Whites who do so. This makes Hispanics a potential growth opportunity and an important target to consider. Consequently, Medicare Advantage carriers could enhance their existing efforts to better their plans by developing culturally-relevant communication platforms and staff training programs focused on improvements in quality care. While, not all Hispanic Medicare beneficiaries are eligible by age, approximately 78% of Hispanic Medicare Advantage enrollees are eligible by age, and 22% are eligible by disability status. The majority of Hispanic Medicare Advantage enrollees are also between the ages of 65 to 74. “Medicare Advantage carriers may sometimes underestimate the size of the multicultural segment,” said George L. San Jose, president and chief creative officer at The San Jose Group. “By realizing that Hispanics and African Americans enroll in Medicare supplemental plans more often, and developing the pertinent communication platform, an important impact on the bottom line can be promptly...
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By Martha C. Rivera, Director of Strategy and Insights With the support of Nicha Ruchirawat, Junior Executive Medicare-related provisions are important components of the Health Care Law that will surely have a strong impact on multicultural segments. The ACA includes new rules that strengthen the Medicare program. Figures show that the multicultural group makes up a significant portion of Medicare participants who will be affected by this reform. Currently, approximately 16% of Hispanics and 23% of African Americans are enrolled in this federal insurance program, who will benefit from the ACA provisions aimed to decrease costs and ensure better protection to enrollees: 1. Closing the doughnut hole: Those who have Prescription Drug Coverage on their Medicare plan will get 50% discount on brand-name drugs and 14% discount on generic prescription drugs if they fall into the coverage gap. The coverage gap will narrow by year until it disappears in 2020. 2. Increased preventive care coverage: Cost-free preventive care services that were not part of the Medicare package before ACA, such as yearly wellness tests and screenings for diabetes, will be provided. Today, approximately 34 million Americans in traditional Medicare and Medicare Advantage plans have received at least one preventive service. 3. Improved access to primary care doctors: Primary care doctors and nurses receive bonus payments if they provide quality care, or provide primary care in areas with doctor shortages. 4. Ensure future protection: Life of Medicare Trust fund extended to at least 2029, which is a 12-year extension. Although the Medicare component of the ACA has received less media attention than some controversial issues of the law, it has already started its implementation process. For instance, by 2013, more than 1,550 hospitals were rewarded as the establishment of Medicare value-based purchasing program for incentivizing providers moves forward. Source: The Affordable Care Act (ACA) of 2010: May 2013 Progress Report. Deloitte Center for Health Solutions. Cover Photo Source: txking /...
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By Martha C. Rivera, Director of Strategy and Insights Consumer education should be at the core of any efforts to implement the ACA. As the deadline for enrollment through health insurance market places approaches and the government and health insurance organizations rush out to be up and running within the Exchanges by October 1, all of them at the local and national level should be developing strong consumer education strategic platforms as well. Otherwise, how can they drive the uninsured for enrollment starting in January 1, 2014, when more than 78% of the people who would be eligible for enrollment through the Exchanges have never heard of them? “Creating awareness of the ACA’s key components and milestones, providing plain-language, culturally-sensitive understanding of the Exchanges at a general level and generating consumer intention to learn more about what can be in the ACA for them are three key objectives that Exchange-related education should accomplish in the immediate term,” said George L. San Jose, president and chief creative officer at The San Jose Group. A recent study sponsored by the Robert Wood Johnson Foundation, revealed that, after being provided with general information on the matter, about 73% of people who would be eligible for enrollment through Exchanges would be interested in doing so, while 55% use the internet on a daily basis and 79% would confide on their internet-related skills for that. Source: http://www.rwjf.org/content/dam/farm/reports/surveys_and_polls/2012/rwjf73113...
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